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Organization
TETON MRI OF IDAHO FALLS
Active
Organization
TETON MRI OF IDAHO FALLS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BONNIE C. GRAY (ADMINISTRATIVE ASSISTANT)
(208) 552-0828
Entity
Organization
Contact information
Practice address
2060 S WOODRUFF AVE, IDAHO FALLS, ID 83404-6396
(208) 552-0828
(208) 552-0829
Mailing address
2060 S WOODRUFF AVE, IDAHO FALLS, ID 83404-6396
(208) 552-0828
(208) 552-0829
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Enumeration date
09/06/2005
Last updated
07/10/2007
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